National University of Health Sciences

Nigella sativa seed (NSS), also known as black seed (BS), black cumin, kalonji, black caraway, or habat al baraka (blessed seed), have gained attention for their potential therapeutic effects in managing metabolic syndrome (MS). Black seeds contain fatty acids (35-40%), carbohydrates (30-37%), proteins (20-23%), ash (5-8%), fibers (3-7%), phenolics (1.5-3.5%), minerals (1.5-3.5%), and DNA/RNA (<1%). Although BS contains ~ 1% volatile oils such as thymoquinone, carvacrol, and p-cymene, most of the BS studies orbit around thymoquinone (TQ). The medicinal importance of the major components of BS, including carbohydrates, proteins, and phenolics, is currently evolving. The different bioactive components of Nigella sativa seed extract (NSSE) or Nigella sativa seed powder (NSSP) block MS through a variety of mechanisms, such as antioxidant, anti-inflammatory, anti-dyslipidemic, antidiabetic, anti-hypertensive, and hepatoprotective activities. MS is a cluster of metabolic conditions, such as high blood sugar, dyslipidemia, obesity, and high blood pressure, that occur together, increasing the risk of type II diabetes mellitus, non-alcoholic fatty liver disease (NAFLD), heart disease, kidney disease, cancer, and more. There is no precise review article discussing the mechanistic effects of NSSE or NSSP on MS in all forms of scientific studies. The review aims to provide a comprehensive look at the mechanistic effects of NSSE or NSSP, considering all active components beyond just thymoquinone.

Background: Despite effective recording practices, there are no published data on surgical emergencies at Sohar Hospital. Understanding this data will enable policymakers and surgeons to enhance the efficiency, cost-effectiveness, and quality of emergency services, ultimately improving patient care. This study aims to document the patterns of emergency surgical diseases at Sohar Hospital and the immediate outcomes of their management. Methods: This is a descriptive, prospective study of patients admitted to Sohar’s surgical emergency department between February 10 and March 10, 2023. Ethical approval was obtained, and data collection was performed using a form. Analysis was conducted using SPSS. Results: The study involved 272 patients. Among them, 31 (11.4%) were trauma patients, while 241 (88.6%) were non-trauma patients. Most trauma patients (80%) were under the age of 42, and 71% experienced road traffic accidents. More than half of the non-trauma patients (53.5%) presented with an acute abdomen, of which 44% reported nonspecific abdominal pain. The most commonly diagnosed acute abdominal condition was appendicitis, followed by cholecystitis, intestinal obstruction, diverticulitis, and peptic perforations. Regarding the immediate outcomes, 46.7% of the patients were treated in the emergency department and discharged, 22.1% were admitted and operated on, 16.2% were admitted and treated conservatively, 7.4% discharged themselves against medical advice, and 5.5% were referred to other specialties. The mortality rate was 2.2%, primarily due to sepsis. Conclusion: The study revealed the pattern of emergency surgical disease at Sohar Hospital, patient demographics, and treatment outcomes. This data is essential for effective resource allocation and improving patient care. Further research is necessary.

The practice of Ramadan fasting, as intermittent fasting, is growing in popularity because of its ability to prevent cancer development. The practice of fasting allows patients to experience multiple changes at metabolic, physiological, and epigenetic levels, which reduce cancer advancement and better their response to treatment. The study performs a systematic review of published studies to explore protective mechanisms within this investigation about assurance of scientific integrity and transparency. The authors have implemented the standards included in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The research demonstrates how fasting metabolism affects ketone body production while reducing glucose availability and simultaneously lowering both insulin and insulin-like growth factor-1 (IGF-1) levels. Proliferation control of cancer cells depends heavily on these three regulatory factors. The DNA damage response (DSR) becomes more effective while cellular homeostasis maintains itself because fasting-induced autophagy accomplishes both cellular component elimination and defective cellular component clearance. The reduction of oxidative stress caused by fasting leads to constrained development of malignant cell transformations and protects against DNA. The epigenetic effects of fasting during Ramadan result in non-coding RNA regulation, together with DNA methylation and histone remodeling processes to turn on beneficial tumor suppressor genes and deactivate cancer-causing oncogenes. The latest research supports the potential role of fasting as an additional form of care for fighting and stopping cancer development. These findings lead to major impacts on clinical applications and dietary remedies, and public health policy within integrative cancer treatment.

Primary care physicians (PCPs) care for patients from cradle to grave, across multiple disciplines and within the context of the family. They are thus well-placed to provide genomic education and clinical services to their patients in partnership with Genetics Healthcare Professionals (GHPs). However, the specific role of PCPs to support genomic medicine is unclear, and hence a review was conducted to understand the ways PCPs can integrate genomic medicine practices. Materials and Methods: Relevant publications were retrieved from Google Scholar and PubMed using the keywords of "Genomics", "Primary Care Physicians", and "Role". Main results: Thirty-seven retrieved articles provided information that is included in this review. PCPs need to increase their knowledge and understanding of genomics; develop competency in the collection of family histories; have knowledge of the genetic screening tests available; know when to refer their patients for genetic screening; and be able to manage ethical, legal, and social issues that may arise. Conclusion: PCPs play an essential role in the provision of appropriate genomics services, in improving access, in co-managing patients with GHPs, and in providing scientific understanding of genomics to the community.

Background: Most systems of traditional medicine have been using herbal medicines to prevent and treat acute respiratory conditions and various other conditions for centuries. The aim of this project is to identify and examine the systematic and narrative reviews reporting on the therapeutic use of herbal medicines as it relates to the prevention and treatment of COVID-19 and long COVID. Methods: This paper is part of an umbrella review of studies related to natural health products and natural therapies for the prevention or treatment of COVID-19. It is a follow-up to a live review that was conducted by the World Naturopathic Federation between May 2022 and May 2023. PubMed and Google Scholar were searched for systematic and narrative reviews that met defined quality criteria. Results: Over half of the initial systematic reviews were excluded as they did not meet the inclusion and AMSTAR criteria. The final paper included 25 narrative reviews and 41 systematic reviews (SR), with half of the SRs reporting on the safety of herbal interventions. Various therapeutic properties of over 60 herbal medicines were outlined, some individually and most of them as part of herbal formula (combinations). Conclusion/Summary: Herbal interventions demonstrated statistically significant improved recovery in patients with COVID-19. The most common therapeutic properties identified were immunological properties, anti-inflammatory, anti- microbial, and antioxidant while the most frequently investigated herbs were Glycyrrhiza glabra/uralensis, Tinospora cordifolia, and Curcuma longa. More attention is needed on the regulation of herbal medicines, the quality of research, and the safety of herbal medicines.

Spinal pain and chronic health conditions are highly prevalent, burdensome, and costly conditions, both in the United States and globally. Using cross-sectional data from the 2016 through 2018 National Health Interview Survey (n = 26,926), we explored associations between spinal pain and chronic health conditions and investigated the influence that a set of confounders may have on the associations between spinal pain and chronic health conditions. Variance estimation method was used to compute weighted descriptive statistics and measures of associations with multinomial logistic regression models. All four chronic health conditions significantly increased the prevalence odds of spinal pain; cardiovascular conditions by 58%, hypertension by 40%, diabetes by 25% and obesity by 34%, controlling for all the confounders. For all chronic health conditions, tobacco use (45-50%), being insufficiently active (17-20%), sleep problems (180-184%), cognitive impairment (90-100%), and mental health conditions (68-80%) significantly increased the prevalence odds of spinal pain compared to cases without spinal pain. These findings provide evidence to support research on the prevention and treatment of non-musculoskeletal conditions with approaches of spinal pain management.

Objective: Both the United Nations and the World Health Organization have identified antimicrobial resistance as a significant threat to global health. The Centers for Disease Control and Prevention identified five pediatric respiratory conditions as requiring particular scrutiny in terms of antibiotic stewardship. This study sought to identify strategies used by experienced naturopathic practitioners to treat acute respiratory infections in children. The authors theorize that naturopathic strategies safely fill the gap between watchful waiting and antibiotic prescription, thus reducing the use of antibiotics. Methods: Naturopathic practitioners in Canada, the United States, and Australia with a minimum of 5 years of experience in clinical naturopathic care of children were recruited for a modified Delphi study. A 14-person panel of practitioners was selected to complete a series of four iterative surveys assessing agreement to statements in five domains of knowledge/attitudes, assessment/diagnosis, management, monitoring, and education. Items were deemed to have reached consensus if they reached a predetermined threshold of 70% agreement, or failed to reach a threshold of 40% agreement. Items between these boundaries were modified and retested until either consensus was reached or the four surveys had been completed. Results: Results yielded a large degree of agreement on core naturopathic approaches to the management of acute pediatric respiratory infections, especially lifestyle strategies, including adequate rest and dietary recommendations. The use of vitamins C and D was strongly supported, as were herbs, particularly echinacea and elderberry. Some hydrotherapy and topical applications specific to the individual focus on infection also reached consensus. Results suggested that most respondents, even if they have the authority to prescribe antibiotics, rarely deem it necessary to do so. Conclusion: Findings of this study provide (1) clarity on the role of naturopathic doctors in the management of pediatric health concerns and the stewardship of antibiotics; and (2) initial guidance to less experienced naturopathic practitioners. The findings also identify key priorities for research into the safety and effectiveness of naturopathic interventions to reduce the unnecessary prescribing of antibiotics.

Objective: The study objective was to quantify the changes in intradiscal pressure (IDP) during the application of a chiropractic procedure known as the Cox flexion-distraction technique. Materials and Methods: Pressure sensors were inserted into lumbar intervertebral discs of eight unembalmed cadavers (five male and three female, age range 43–75 years). Five 4-second cycles of flexion distraction were performed for a 20-sec period. Pressure data were collected while the discs were in an unpressurized state as well as a pressurized state (with water). The pressure data were collected during three separate applications of the flexion-distraction procedure with transducers inserted into the L2-L3, L3-L4, and L4-L5 intervertebral discs. The mean pressure values were documented before, during (in the distracted position), and after the treatment procedure (calculated). Pressure differences were compared using the paired t-test for significance in pressure changes from initial prone position to distracted treatment position. Results: The IDPs significantly decreased in both pressurized and unpressurized discs at all studied disc levels. The average IDP decreases in unpressurized discs were as follows: 5.6 kPa at L2-L3, 20.6 kPa at L3-L4, and 22.0 kPa at L4-L5. The IDP decrease range in pressurized-in-the-initial-prone-position discs were as follows: 17.8 kPa at L2-L3, 35.2 kPa at L3-L4, and 122.0 kPa at L4-L5. Conclusions: IDP was found to decrease during the flexion-distraction procedure, which is consistent with the hypothesis that this procedure may be able to draw a protruded nucleus pulposus back toward the intervertebral disc's center and allow for the nutrients flow into the disc.

The purpose of this quantitative, correlational study was to investigate the relationships between perceived online student engagement and self-reported grade point average (GPA) among post-licensure, undergraduate nursing students. Participants for this study were RN-to-BSN students at a mid-sized university in the Midwest. Approximately 110 students were contacted for participation, with 27 complete student responses (N= 27). Study participants were predominately 36 years or older (63%), full-time students (55.6%), and female (77.8%). The Community of Inquiry survey instrument by authors Arbaugh et al. (2008) measured perceived student engagement. Significant, positive correlations among the variables of cognitive presence (rs= .467, p= .014), teaching presence (rs= .448, p= .019), and self-reported GPA were determined among RN-to-BSN students. Significant effect differences were found between student engagement groups and self-reported GPA (p< .05); thus, within this study, student engagement significantly related to academic outcomes. Subsequently, the utilization of institution standards that heighten online student engagement could relate to improved student academic outcomes for RN-to-BSN students.